Khurshid Aiman, Khurshid Maman, Sohail Aruba, Raza Imran Mansoor, Ahsan Muhammad Khubab, Alam Shah Mir Umer Farooq, Taseer Anab Rehan, Nashwan Abdulqadir J, Ullah Irfan
Department of Forensic Medicine Abbasi Shaheed Hospital Karachi Pakistan.
Department of Internal Medicine Dow University of Health Sciences Karachi Pakistan.
Health Sci Rep. 2022 Oct 28;5(6):e887. doi: 10.1002/hsr2.887. eCollection 2022 Nov.
Facial palsy is a rare complication of the COVID-19 infection. Herein, we conducted a systematic review of all published cases of facial palsy post-COVID-19 infection in an attempt to educate the general population and medical practitioners regarding the likely occurrence of facial palsy in COVID-19 patients, its detection, effective treatment plan, and prognosis of the condition.
We searched PubMed, Google Scholar, and Directory of Open Access Journals (DOAJ) from December 1, 2019 to September 21, 2021.
We included 49 studies bearing accounts of 75 cases who had facial palsy. The mean age of patients was 42.9 ± 19.59 years, with a male-to-female ratio of 8:7. The majority of the cases were reported from Brazil ( = 14), USA ( = 9), Turkey ( = 9), and Spain ( = 9). Noticeably, 30.14% of COVID-19 patients were diagnosed with Guillain-Barré syndrome. In total, 22.97% of patients complained of bilateral facial paralysis ( = 17), whereas ipsilateral paralysis was observed in 77.03% ( = 57). These were common complaints of Lagophthalmos, otalgia, facial drooping, dysarthria, and compromised forehead wrinkling. The treatment regimen mainly included the use of corticosteroids ( = 51) (69.86%), antivirals ( = 23) (31.51%), IVIG ( = 18) (24.66%), antibiotics ( = 13) (17.81%), antiretroviral ( = 9) (12.33%), and antimalarial ( = 8) (10.96%) medications. In all, 35.62% of patients ( = 26) adhered to a combination of antiviral and corticosteroid-based therapy. Positive treatment outcomes were observed in 83.58% ( = 56) of cases. In contrast, 10 patients (14.93%) showed nonsignificant recovery, out of which 3 (4.48%) died from the disease.
The association of facial palsy with COVID-19 is controversial and therefore requires further investigation and published work to confirm a causal relationship. However, physicians should not overlook the likelihood of facial palsy post-COVID-19 infection and treat it accordingly.
面神经麻痹是新冠病毒感染的一种罕见并发症。在此，我们对所有已发表的新冠病毒感染后发生面神经麻痹的病例进行了系统综述，旨在让普通民众和医学从业者了解新冠病毒感染患者发生面神经麻痹的可能性、其检测方法、有效的治疗方案以及病情的预后情况。
我们在2019年12月1日至2021年9月21日期间检索了PubMed、谷歌学术和开放获取期刊目录（DOAJ）。
我们纳入了49项研究，这些研究记录了75例患有面神经麻痹的病例。患者的平均年龄为42.9±19.59岁，男女比例为8:7。大多数病例来自巴西（14例）、美国（9例）、土耳其（9例）和西班牙（9例）。值得注意的是，30.14%的新冠病毒感染患者被诊断为吉兰 - 巴雷综合征。总共有22.97%的患者主诉双侧面瘫（17例），而77.03%（57例）观察到同侧面瘫。这些是常见的主诉，包括兔眼、耳痛、面部下垂、构音障碍和额纹减弱。治疗方案主要包括使用皮质类固醇（51例）（69.86%）、抗病毒药物（23例）（31.51%）、静脉注射免疫球蛋白（18例）（24.66%）、抗生素（13例）（17.81%）、抗逆转录病毒药物（9例）（12.33%）和抗疟药物（8例）（10.96%）。总共有35.62%的患者（26例）坚持采用抗病毒药物和皮质类固醇联合治疗。83.58%（56例）的病例观察到了积极的治疗结果。相比之下，10例患者（14.93%）恢复不明显，其中3例（4.48%）死于该疾病。
面神经麻痹与新冠病毒感染之间的关联存在争议，因此需要进一步的调查和已发表的研究来证实因果关系。然而，医生不应忽视新冠病毒感染后发生面神经麻痹的可能性，并应相应地进行治疗。
